May 22

Metrics: Creating a New Model in Healthcare

by Wayne W. Oliver, Vice President, Center for Health Transformation
Originally published in the Atlanta Journal Constitution on March 7, 2012

Whether it is a patient centered medical home (PCMH) or an accountable care organization (ACO), we have all seen or read accounts on how we should change health and healthcare in the United States. And, quite frankly, we must change the dynamics in the healthcare sector to improve patient outcomes, decrease medical errors and lower healthcare costs.

But how do we go about improving the quality of care provided and patient satisfaction? First, it takes measureable data.  Once the information is secured, it requires data analytics to set performance goals or metrics. After all, we have to have a way to measure the metrics that drive how and where we can improve medical care and patient satisfaction.

Many of us read the book or saw the critically acclaimed movie “Moneyball” starring Brad Pitt as the Oakland A’s General Manager Billy Beane.  What was the basis of “Moneyball?” Metrics: using data to put the best possible team on the field at the lowest possible salary. And it worked. The A’s were able to compete with the likes of the New York Yankees and the Boston Red Sox but with a much leaner payroll.

In Rudy Giuliani’s book entitled “Leadership,” the former mayor discussed the creation of Comstat, which centered on mapping where and when crimes were committed in NYC. Comstat was a computer program created by former New York City police commissioner William Bratton.  And it worked. By focusing police resources on where and when crimes were being committed, New York City became the safest large city in America.

So, we are using data, data analytics and metrics to improve results and performance in sports and public safety. But, what data and metrics are being used to improve the healthcare system?

Until recently, there was no meaningful way for healthcare providers including physicians and hospitals to use data to improve medical care because there was no readily available data. The migration of physicians and hospitals to electronic platforms including electronic health records (EHRs) and other data analytic programs has created new opportunities to improve the care provided to patients.

For example, hospitals are using data to set new performance standards for patient safety. Right here in metro Atlanta, Wellstar, a group of five hospitals serving Cobb, Paulding and Douglas Counties, has been on the forefront of using data to create a culture of safety. And, it’s working.

An example of how data and data-driven metrics have resulted in improved care at Wellstar is the neonatal intensive care units (NICU) at Cobb and Kennestone Hospitals.  Increasing staff awareness and using safety coaches in the NICU, so-called “in-line” infections have been reduced to zero and have been maintained at that level in both units for well over 18 months.  To the parents of an under-weight baby, that must be seriously reassuring.

Wellstar is using data and metrics to reduce medical errors in all five hospitals. Several examples are contained in a white paper entitled “Healing without Harm” which was published in 2010 by the Center for Health Transformation.  The white paper, which was released on the decade anniversary of the IOM report entitled “To Err Is Human”, focused on creating and sustaining so-called High Reliability Organizations within healthcare which drive out human errors.

Wellstar is also using employee and patient satisfaction surveys to improve everything from emergency room wait time to creating safety coaches to improve human performance. Dr. Marcia Delk, Senior Vice President and Chief Quality Officer for the Wellstar Health System says, “We are transforming healthcare by using data and applying Lean improvement methodologies and creating a robust safety culture in partnership with improved health information technology to help us address the needs of patients in the communities we serve.”

Wellstar has a team of professionals who are dedicated to using data and performance measures for patient safety efforts, leadership development, revenue cycle improvement, patient satisfaction, employee engagement, operational improvements and medical efficiencies.

So data and metrics can be used in healthcare to improve patient outcomes, reduce medical errors, create a culture of patient safety and develop operational efficiencies. And, Wellstar is proving it can be done.

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